med 610 clinical respiratory diseases & critcare med

Arterial Blood Gas Cases

Here are a series of cases that include arterial blood gases. Each case is followed by an explanation of the acid-base status, the oxygenation status and a summary of the patient's clinical picture.

The explanations of the acid-base status utilize the 5-step approach to interpreting acid-base status that is laid out in the Arterial Blood Gas Primer. In some of the cases, information is not available to calculate the anion gap or the delta delta. In such cases, you should focus solely on identifying the primary and compensatory processes.

  • Case 1>>A 24 year-old woman is found down in Pioneer Square by some bystanders. The medics are called and, upon arrival, find her with an oxygen saturation of 88% on room air and pinpoint pupils on exam.
  • Case 2>>A 60 year-old man with amyotrophic lateral sclerosis is brought into clinic by his family who are concerned that he is more somnolent than normal.
  • Case 3>>A 65 year-old man is brought into the VA hospital with complaints of severe nausea and weakness.
  • Case 4>>A 45 year-old woman with a history of inhalant abuse presents to the emergency room complaining of dyspnea.
  • Case 5>>A 68 year-old man with a history of very severe COPD (FEV1 ~ 1.0L, < 25% predicted) and chronic carbon dioxide retention (Baseline PCO2 58) presents to the emergency room.
  • Case 6>>A climber is coming down from the summit of Mt. Everest.
  • Case 7>>A 57 year-old woman presents with 2 days of fevers, dyspnea and a cough productive of rust-colored sputum.
  • Case 8>>A 47 year-old man with a history of heavy alcohol use presents with a two-day history of severe abdominal pain, nausea and vomiting.